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Handbook of Electrogastrography$
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Kenneth L. Koch and Robert M. Stern

Print publication date: 2003

Print ISBN-13: 9780195147889

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780195147889.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 17 June 2021

The Future and Electrogastrography

The Future and Electrogastrography

(p.213) 9 The Future and Electrogastrography
Handbook of Electrogastrography

Kenneth L. Koch

Robert M. Stern

Oxford University Press

The 3-cycles per minute (cpm) gastric pacesetter potential is a fundamental electrical phenomenon of the stomach. This low-frequency biorhythm is the basis for normal neuromuscular function of the stomach. In regard to the origins and the various neural and hormonal influences that affect the 3-cpm rhythm, many mysteries remain. Ongoing and future inquiries into the very nature of rhythmicity will provide deeper understanding of gastric myoelectrical activity and the electrical activity detected in the electrogastrogram (EGG). The role of knockout mice that lack interstitial cells of Cajal will be increasingly important in understanding the crucial role of rhythmic electrical events in normal and abnormal neuromuscular function of the stomach. These and other animal studies will also continue to help clinicians understand the deficits in gastric neuromuscular function caused by electrical dysrhythmias. A delicate balance maintains normal 3-cpm activity. Stomach electrical rhythmicity is rather unstable during fasting, for example, compared with the rhythmic 3-cpm electrical events and contractile events that occur in the postprandial period. What mechanisms produce these fasting and postprandial electrical changes? Are neural or hormonal circuits most critical? Are extrinsic or intrinsic nerves the most important? Studies of fasting and postprandial EGG activity may offer insights into sensations of hunger and satiety. The EGG signal is responsive to brain-gut interactions such as the cephalic-vagal reflex. Sham feeding studies with healthy subjects indicated that the sight, smell, and taste of food significantly increased 3- cpm activity. However, in subjects who indicated that the sham feeding experience was disgusting, no increase in 3-cpm activity occurred in this situation. Future studies of patients with eating disorders such as bulimia or anorexia nervosa using EGG recording methods may reveal new insights into the pathophysiology of eating disorders and be of value in monitoring the progress of treatment. Different EGG patterns induced by different meals reflect the different gastric neuromuscular work required to receive, mix, and empty the specific meal. Characteristics of the EGG signal from frequency to amplitude may also correlate with perceptions of stomach fullness, hunger, or satiety.

Keywords:   Biofeedback, Eating disorders, Electrocardiogram (EGG) technology

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